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Comparing associations between frailty and mortality in hospitalised older adults with or without COVID-19 infection: a retrospective observational study using electronic health records

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journal contribution
posted on 22.07.2020, 14:06 by Rhiannon Owen, Simon Conroy, Nicholas Taub, Will Jones, Daniele Bryden, Manish Pareek, Christina Faull, Keith Abrams, Daniel Davis, Jay Banerjee
Background
The aim of this study was to describe outcomes in hospitalised older people with different levels of frailty and COVID-19 infection.

Methods
We undertook a single centre, retrospective cohort study examining COVID-19 related mortality using Electronic Health Records, for older people (65 and over) with frailty, hospitalised with or without COVID-19 infection. Baseline covariates included demographics, Early Warning Scores, Charlson Comorbidity Indices and frailty (Clinical Frailty Scale, CFS), linked to COVID-19 status.

Findings
We analysed outcomes on 1,071 patients with COVID-19 test results; 285 (27%) were positive for COVID-19.)The mean age at ED arrival was 79.7 and 49.4% were female. All-cause mortality (by 30 days) rose from 9% (not frail) through to 33% (severely frail) in the COVID negative cohort but was around 60% for all frailty categories in the COVID positive cohort. In adjusted analyses, the hazard ratio for death in those with COVID-19 compared to those without COVID-19 was 7.3, 95% CI: 3.00, 18.0) with age, comorbidities and illness severity making small additional contributions.

Interpretation
In this study frailty, measured using the Clinical Frailty Scale, appeared to make little incremental contribution to the hazard of dying in older people hospitalised with COVID-19 infection; illness severity and comorbidity had a modest association with the overall adjusted hazard of death, whereas confirmed COVID-19 infection dominated, with a seven-fold hazard for death.

History

Citation

Age and Ageing, afaa167, https://doi.org/10.1093/ageing/afaa167

Author affiliation

Department of Health Sciences, University of Leicester

Version

AM (Accepted Manuscript)

Published in

Age and Ageing

Publisher

Oxford University Press (OUP)

issn

0002-0729

Acceptance date

14/07/2020

Copyright date

2020

Available date

17/07/2021

Language

en

Publisher version

https://academic.oup.com/ageing/article/doi/10.1093/ageing/afaa167/5873137

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